右美托咪定对小儿眼科手术后躁动的镇静作用  

reduces postoperative agitation in children received ophthalmologic surgery under Sevoflurane anesthesia

作　　者：王莉娟[1] 卜慧莲[1] 赵京伟[1] 孙雪青[1] 

机构地区：[1]郑州大学第一附属医院麻醉科,郑州450052

出　　处：《中华眼外伤职业眼病杂志》2016年第12期936-939,共4页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的评价右美托咪定（Dexmedetomidine）对七氟醚（Sevoflurance）麻醉下小儿眼科手术术后麻醉苏醒期躁动的镇静作用。方法择期手术患儿60例，年龄3-6岁，随机分为3组，D1组、D2组和C组，麻醉诱导后分别给予0．5μg／蚝右美托咪定泵注、1．0μg/kg右美托咪定及等量生理盐水泵注。记录右美托咪定给药前（T1）、给药后30min（T：）及拔管时（L）心率与血压。麻醉苏醒期行术后躁动评分。记录拔管时间、睁眼时间及离开麻醉恢复室时间。结果3组T1时刻血流动力学变化差异无统计学意义（P=0．35），T2、T3时刻D1组与D2组较c组心率和血压，差异具有统计学意义（P=0．005）。T2、T3时刻，D1组与D2组差异无统计学意义（P=0．19）。术后躁动评分，D，组、D：组均低于C组，差异具有统计学意义（P=0．001）；D2组低于D1组，差异具有统计学意义（P=0．001）。结论右美托咪定能够减少七氟醚全麻下小儿眼科手术术后躁动的发生。其中，1．0μg/kg的右美托咪定减少术后镇静效果更优，降低不良反应的发生。Objective To evaluate the inhibitory effect of Dexmedetomidine on postoperative agitation of children received ophthalmologic surgery under Sevoflurane anesthesia at anesthesia recovery period. Methods Sixty children under Sevoflurane anesthesia, aged 3 - 6 years old, were randomly divided into three groups, namely group D1, group D2 and group C, and received continuous intravenous administration of 0.5μg/kg Dexmedetomidine, 1.0μg/kg Dexmedetomidine, or the same volume of normal saline solution. Heart rate （HR） and mean arterial pressure （MAP） were measured before （ T1 ） and 30 min after administering dexmedetomidine （T2 ）, and at extubation period （T3 ）in all children. Delirium score, extubation time, eye opening time, and time to leave the PACU were recorded. Results There was no significantly difference at T1 time among the three groups in HR and MAP（P =0. 350）. HR and MAP of group D1 and group D2 were significantly lower than those of group C at T2 and T3 time （P =0. 005）. There was no difference in HR or MAP at T2 and T3 time between group D1 and group D2 （P = 0. 190）. Agitation scores of group Dt and group D2 were significantly lower than those group C （ P = 0. 001 ）. Delirium scores of group D2 were significantly lower than those of group D1（ P = 0. 001 ）. Conclusion These resuhs suggest that continuous intravenous administration of Dexmedetomidine can reduce postoperative agitation. Intravenous administration of 1.0μg/kg Dexmedetomidine is more effective with less adverse events.

关 键 词：右美托咪定 小儿 眼科手术 术后躁动 术后镇静 

分 类 号：R614.2[医药卫生—麻醉学]